Multiple complications of wound infection of mixed etiology: clinical case

Abstract

Purpose: to demonstrate a case of mixed purulent wound infection of the leg with the sequential development of multiple complications — phlegmon, staphylococcal infection with scarlet-like syndrome and the skin-articular form of Henoch-Schönlein hemorrhagic vasculitis in a 12-year-old child. Results. A severe, complicated form of purulent lesions of the skin and subcutaneous tissue is described — phlegmon of the lower leg, which arose as a result of infection of previously damaged tissues by the main causative agents of mixed wound infection — S. aureus and S. pyogenes in the IV degree of contamination. On the 7th day of the disease, the manifestation of an immune complex complication was noted — the skin-articular form of Henoch-Schönlein hemorrhagic vasculitis and symptoms of staphylococcal infection with scarlet-like syndrome, which required a differential diagnosis with wound (extrabucal) scarlet fever.

 Conclusion. The difficulties of differential diagnosis are shown. The delayed appearance of the rash on the 7th day of illness, pronounced hyperemia of the skin with a cyanotic tint around the wound, the formation of a large affected area, the appearance of peeling of the skin earlier than with scarlet fever — already against the background of a fading rash, allowed us to think about a staphylococcal infection with scarlet fever-like syndrome.